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Risk of Incident Osteoarthritis of the Hand in Statin Initiators: A Sequential Cohort Study
Author(s) -
Burkard Theresa,
Hügle Thomas,
Layton J. Bradley,
Glynn Robert J.,
Bloechliger Marlene,
Frey Noel,
Jick Susan S.,
Meier Christoph R.,
Spoendlin Julia
Publication year - 2018
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23616
Subject(s) - medicine , hazard ratio , propensity score matching , statin , proportional hazards model , confidence interval , cohort , osteoarthritis , cohort study , medical prescription , physical therapy , pharmacology , alternative medicine , pathology
Objective To investigate the association between statin therapy initiation and incident hand osteoarthritis (OA). Methods We performed a propensity score–matched cohort study using data from the UK‐based Clinical Practice Research Datalink. Statin initiators had ≥1 statin prescription between 1996 and 2015 and were matched 1:1 on their propensity score to noninitiators within 10 sequential 2‐year cohort entry blocks. After a 180‐day run‐in period, patients were followed in an as‐treated approach until a recorded diagnosis of hand OA or until censoring (change in exposure status, development of an exclusion criterion, or maximum follow‐up of 5.5 years). We applied Cox proportional hazard regression to calculate hazard ratios (HRs) with 95% confidence intervals (95% CIs) overall and in subgroups of sex, age, statin dose, statin agent, preexisting dyslipidemia, and treatment duration. To compare results, we ran all analyses with negative and positive control outcomes and assessed generalized OA as a secondary outcome. We further performed the overall analysis with an active comparator (topical glaucoma therapy initiators). Results Among 233,608 statin initiators and the same number of noninitiators, we observed an overall HR for hand OA of 0.98 (95% CI 0.88–1.09). The observed null result remained unchanged in all subgroups. Results were highly similar for generalized OA and negative control outcomes. In addition, the active comparator analysis showed a null result with an HR for hand OA of 0.85 (95% CI 0.56–1.29). Previously known associations with positive control outcomes were observed. Conclusion There was no association between statin initiation and incident hand OA in this study.